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Colony stimulating factors for prophylaxis of chemotherapy-induced neutropenia in children

Heeyeon Kim1, Shaker A Mousa1

  • 1The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, NY, USA.

Expert Review of Clinical Pharmacology
|August 5, 2022
PubMed

Insights

Granulocyte colony-stimulating factors (G-CSFs) effectively reduce febrile neutropenia in pediatric cancer patients. Standard doses of filgrastim or pegfilgrastim are recommended for prophylaxis, though more research is needed.

Area of Science:

  • Pediatric Oncology
  • Hematology

Background:

  • Febrile neutropenia (FN) is a serious chemotherapy complication increasing infection risk and mortality.
  • Granulocyte colony-stimulating factors (G-CSFs) are used to manage neutropenia, but their role in pediatric FN prophylaxis is understudied.

Purpose of the Study:

  • To review the efficacy and safety of G-CSFs for primary prophylaxis of FN in pediatric cancer patients.
  • To evaluate current G-CSF dosing and administration guidelines in this population.

Main Methods:

  • Systematic review of clinical trials published between 2002 and 2021.
  • Analysis of G-CSF (filgrastim and pegfilgrastim) dosages and outcomes in pediatric cancer patients.

Main Results:

  • Filgrastim (5 mcg/kg/day) reduced fever duration, hospital stay, and antibiotic use in high-risk neuroblastoma patients.
  • Pegfilgrastim (100 mcg/kg single dose) demonstrated similar efficacy in preventing FN and infections, with bone pain as a noted side effect.

Conclusions:

  • Standard G-CSF doses are appropriate for pediatric cancer patients weighing over 45 kg, administered at least 24 hours post-chemotherapy.
  • Further prospective randomized trials are essential to confirm G-CSF efficacy and safety across diverse pediatric cancer types.
Abstract

Keywords:
Chemotherapy-induced neutropeniaG-CSFGM-CSFfebrile neutropeniagranulocyte colony stimulating factorspediatric cancer

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